The issue of withdrawing food and fluids from brain damaged patients is complex and little understood - Care Not Killing was on hand to outline concerns with the Supreme Court's ruling on a busy media day

Having heard an appeal by the Official Solicitor in February 2018, the Supreme Court upheld a ruling that decisions to withdraw Clinically Assisted Nutrition and Hydration (CANH) from people with Prolonged Disorders of Consciousness (PDOCs - including Vegetative and Minimally Conscious States) need not be approved by the Court of Protection where families and clinicians were in agreement. Taking these decisions away from the Court of Protection removes an important layer of legislative scrutiny and accountability and effectively weakens the law.

At the moment, because of the current policy of involving the court in all such cases, the number of cases we see is very few (fewer than 100 in over 20 years). But with the Court removed from the equation, this could very well lead to a huge escalation of cases, given how many people in Britain have either PVS or MCS.

There are still significant uncertainties about diagnosis and prognosis in both PVS and MCS. These have increased rather than decreased since the Bland case and this is why continued court endorsement of the withdrawal of life-sustaining nutrition and hydration in such cases is necessary. Well-intentioned people - relatives, carers and clinicians - often make mistakes about diagnosis/prognosis and accordingly, agreement between all of them about withdrawal of CANH is not adequate protection.